Good Faith Estimate

You have the right to a good faith estimate…

A patient may ask for an estimate of the amount the patient will be charged for a nonemergency medical service provided in our office. The law requires that an estimate be provided within 5 business days of scheduling the nonemergency health care service unless the nonemergency health care service is scheduled to be performed by the practitioner within 5 business days of the date of the patient’s request.

We would be happy to work with your insurance company to provide an estimate of charges for any non-emergent appointment you are scheduling in our office. Please contact our billing department to make your request PRIOR to scheduling an appointment.

Become a Patient

Please download and complete the appropriate new patient packet.  One of our staff will contact you within a few days of receiving your completed forms.   Please include a copy of your insurance card(s) with your packet.  You may bring your fully completed packet by the office, fax it to 812-524-3334, or use our upload form.